Senate: You Can End HIV in America. It's On You | Opinion
Envision a future where there is not one new case of HIV in America. This can become our reality as early as 2030—should our lawmakers choose to act.
Today, nearly 40,000 Americans are diagnosed with HIV each year, and each of them faces living with the trauma of a chronic health condition. Yet, they can all live a life with few interruptions if they have access to today's groundbreaking medical advancements. Hospitals are no longer graveyards of gay men whose lives were tragically extinguished far too soon, but the height of the AIDS epidemic remains fresh in the minds of many. And for those of us who have survived, the weight and responsibility of that legacy—of those we lost, the decades of activism that transformed a nation, and the progress we've fought for—are heavy burdens, but ones we carry for ourselves and for others into the future.
The face of HIV today does not resemble the images many of us remember dating back to the 1980s and 90s. What was widely seen as a coastal epidemic, concentrated in urban centers like San Francisco and New York, has increasingly shifted its geographic focus to our Southern states. In 2017, the last year we have CDC data for, the South made up 52 percent of new HIV cases in the United States, and nearly a quarter of those individuals live in suburban and rural areas. Those places present a unique set of challenges as we work to prevent new cases and treat those who are living with a diagnosis. Moreover, black Americans, who make up 13% of the country's population, accounted for 43 percent of new HIV cases in 2017. If current trends persist, one in two black gay men may be diagnosed with HIV in their lifetime. These are the realities we're up against today—and what we should all be focusing our energy on when we speak about ending this epidemic once and for all.
We've made tremendous progress since those frightening days in the 1980s and 90s. Achieving viral suppression not only makes living long and healthy lives with HIV possible but having a consistent undetectable viral load means you cannot transmit HIV. And if you are HIV-negative, a medication called PrEP can prevent you from acquiring the virus. But for too many, this historic progress is not being felt. From black Americans to the Latinx community, to transgender Americans, persistent barriers to adequate healthcare pose a serious threat.
Between the two of us—each a black gay man living with HIV—we know what it's like to struggle with homelessness, to watch a partner die of AIDS, and to be on the receiving end of prejudice and stigma because of our HIV status. We both also have the privilege of leading two of the nation's largest HIV advocacy organizations. That responsibility is not lost on us, especially while many marginalized communities we advocate for continue to slip through the cracks and find themselves denied the life-saving healthcare and treatment afforded to those with means. Despite last month's Pride celebrations and commemoration of 50 years of progress since the Stonewall riots, we cannot lose sight of the challenges we've yet to overcome. Ending the HIV epidemic is a major public health challenge, but it is finally within reach.
Earlier this year, President Trump announced his Administration's goal to end the epidemic of HIV in the United States by 2030. While we were encouraged by this announcement, we all need to do more in order to see that goal achieved. That includes allocating more than just the critical new money the President proposed. The President needs to square his call to action with other policies stemming from his Administration that harm and threaten vulnerable communities, especially the LGBTQ population and women's reproductive health. From his appointment of vocal opponents of gay rights to his implementation of a trans-military ban—the degradation by this Administration of gay and transgender Americans who are most impacted by HIV is well known and runs counter to its goal of ending the epidemic.
In June, the House members of Congress upped the ante and passed their appropriations bill which includes new funds for not only implementing the Administration's plans to end the HIV epidemic but for combating soaring STD rates which are known to exacerbate the epidemic. The House bill addresses years of flat funding and provides sorely needed increased funding to HIV, STD, and hepatitis prevention and the Health Resources and Services Administration (HRSA), the Ryan White Care Program, Centers for Disease Control and Prevention's opioid and infectious disease program, for HIV research, and for the Minority HIV/AIDS Fund.
The rampant stigma that persists today keeps many from knowing their HIV status. Systemic barriers—lack of access to health care, implicit bias and discrimination, homophobia—are clear and present dangers to the health of all Americans. But it doesn't have to be that way. The fight to end HIV in our lifetimes is possible, and the strategy put forth by the Trump Administration is a path forward. But we must hold our elected leaders accountable, and ensure that money isn't thrown at this issue in a haphazard and ill-informed manner.
Last week, the President and Congressional leaders agreed on a sweeping budget and debt ceiling deal that includes billions in additional domestic spending over the next two years and prevents another government shutdown. Followed by passage in the House, we are optimistic that the Senate will also vote to raise the spending caps included within the framework of the budget deal, and urge the Senate to support the funding levels passed by the House last month to implement this new strategy to end HIV. Building upon hard-fought gains in tackling the HIV epidemic and focusing on the syndemic problems that surround the disease will require increased investments and ongoing support to address this public health crisis that has plagued the most vulnerable of Americans for over three decades.
It's time we honor the memories of the more than 650,000 Americans who have died as a result of this terrible epidemic. We can do that by saving the lives of the over one million Americans living with HIV and the million or more most vulnerable to acquiring the disease. We can usher in a better tomorrow for all.
We urge Congress, particularly Republicans representing the South who must face this public health crisis of HIV in their own backyard head-on, to take action in ending the HIV epidemic in this country by 2030.
Jesse Milan Jr. is President and CEO of AIDS United. Terrance Moore is Acting Executive Director of NASTAD (National Alliance of State & Territorial AIDS Directors.)
The views expressed in this article are the author's own.
